{126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]
treprostinil
RxCUI: 2630671
What the CMS Formulary Data Shows for {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]
Per the CMS 2026 Part D formulary file, {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] (RxNorm concept RXCUI 2630671, generic name treprostinil) appears on 100 distinct formulary files spanning 1,559 Medicare Part D plan offerings - 30.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.6.
Real-world access to {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 35% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] today.
Coverage Details
- Formularies covering
- 100
- Plans covering
- 1,559
- Coverage rate
- 30.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 35% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T5 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | Yes | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $0 | MO |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | Yes | $0 | MA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | Yes | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | Yes | $5.00 | OK |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | Yes | $15.20 | IL |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | Yes | $31.20 | MD |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | Yes | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | Yes | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | Yes | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | Yes | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | Yes | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | Yes | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY | T1 | Yes | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | Yes | $43.00 | MO |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T4 | Yes | $0 | OR |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T5 | Yes | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T5 | Yes | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T5 | Yes | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | T5 | Yes | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | UNITEDHEALTHCARE INSURANCE COMPANY | T5 | Yes | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | UNITEDHEALTHCARE INSURANCE COMPANY | T5 | Yes | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | UNITEDHEALTHCARE INSURANCE COMPANY | T5 | Yes | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | UNITEDHEALTHCARE INSURANCE COMPANY | T5 | Yes | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | ARIZONA PHYSICIANS IPA, INC. | T5 | Yes | $0 | AZ |
Frequently Asked Questions
Is {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] covered by Medicare Part D?
Yes, {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] is covered by 1,559 Medicare Part D plans (30.8% of all Part D formularies).
What tier is {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] on Medicare Part D plans?
{126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] averages Tier 4.6 across Part D plans, ranging from Tier 1 to Tier 5.
Does {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit] require prior authorization?
100% of Part D formularies require prior authorization for {126 (12 HR treprostinil 0.125 MG Extended Release Oral Tablet [Orenitram]) / 42 (12 HR treprostinil 0.25 MG Extended Release Oral Tablet [Orenitram]) / 84 (12 HR treprostinil 1 MG Extended Release Oral Tablet [Orenitram]) } Pack [Orenitram Month 3 Titration Kit]. Step therapy: 0%. Quantity limits: 35%.
Read our methodology - how this data is sourced, computed, and verified.